We urge Congress to protect access to care in underserved communities and support the safety net by rejecting site-neutral policies.
view more »It Takes a Village: University of Miami Community Paramedicine Training Shapes the Future of Statewide Care
Nov. 4, 2022 ||Leaders at UHealth have shaped local and statewide care services through their community paramedicine training program and say it's the future of American health care.
view more »MedPAC Considers Safety Net Funding, Site-Neutral Policies
June 20, 2022 ||The commission's June report to Congress includes illustrative policies about defining and supporting Medicare safety net providers and aligning payments across outpatient settings, among other topics of interest to essential hospitals.
view more »Statement on 2022 Medicare OPPS Proposed Rule
July 19, 2021 ||America's Essential Hospitals expresses its disappointment with the administration's decisions to stand by a bad policy on Part B drug payments and to continue damaging cuts to outpatient care.
view more »CMS to Reprocess 2019 OPPS Claims at Site Neutral Rates
Jan. 15, 2021 ||The Centers for Medicare & Medicaid Services will begin reprocessing outpatient claims to excepted off-campus provider-based departments at the lower site neutral payment rate it established in the calendar year 2019 Outpatient Prospective Payment System final rule.
view more »OPPS Final Rule Continues 340B, Site-Neutral Cuts
Dec. 4, 2020 ||The Medicare Outpatient Prospective Payment System final rule for calendar year 2021 continues cuts to hospitals in the 340B Drug Pricing Program and off-campus provider-based departments, and updates the overall hospital star ratings methodology.
view more »Ruling on Outpatient Payment Cuts Jeopardizes Access to Care
July 17, 2020 ||The U.S. Court of Appeals decision allows the Centers for Medicare & Medicaid Services to maintain its policy of deep cuts to payments for outpatient care, which will widen gaps in health care access in communities across the country.
view more »CMS Proposes Extension, Changes to Joint Model
Feb. 25, 2020 ||A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.
view more »Hospital Compare January Preview Reports Include Star Ratings
Nov. 5, 2019 ||Health care providers have until Dec. 3 to download their preview reports, which include overall hospital quality star ratings.
view more »On the Hill: Congress Reviews Trump’s Medicare, Medicaid Proposals
March 12, 2019 ||The president's fiscal year 2020 budget plan calls on Congress to significantly reform the two programs, including ending Medicaid expansion and changing Medicare uncompensated care payments.
view more »2018 Physician Fee Schedule Cuts Outpatient Payments
Nov. 3, 2017 ||The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.
view more »The final rule's cuts to Medicare Part B drug payments to 340B hospitals jeopardizes health care access for millions of low-income individuals and families nationwide and weakens the ability of essential hospitals to provide vital services to communities.
view more »Physician Fee Schedule Proposed Rule Cuts Outpatient Payments
July 17, 2017 ||The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.
view more »CMS Publishes Medicare Outpatient Observation Notice FAQs
March 14, 2017 ||The FAQs outline how hospitals should complete the form's free-text field and clarify that the form must be issued to Medicare Advantage enrollees.
view more »Medicare Outpatient Observation Notice Required Starting March 8
Feb. 27, 2017 ||Hospitals will be required to provide the form and accompanying instructions to applicable Medicare patients starting March 8.
view more »CMS Offers Medicare Outpatient Observation Notice Guidance
Jan. 31, 2017 ||The new guidance outlines how and when hospitals must deliver the notice, retention requirements, and how the notices intersect with state laws.
view more »New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances.
view more »New Parkland Clinic Will Continue Ron Anderson’s Legacy
Dec. 14, 2016 ||The new 227,420-square-foot clinic will build on the former CEO's vision of ensuring health care for the most vulnerable among us.
view more »Medicare Outpatient Observation Notice Form Finalized
Dec. 9, 2016 ||All hospitals and critical access hospitals will be required to provide the MOON to applicable patients beginning March 8, 2017.
view more »On the Hill: 21st Century Cures, Government Funding
Dec. 7, 2016 ||Congress plans to vote on a continuing resolution to keep the government running past Dec. 9. The Senate is expected to pass 21st Century Cures legislation.
view more »2016 Advocacy Year-in-Review
Dec. 5, 2016 ||In this webinar we looked back at the 2016 advocacy landscape, discussed the progress we have made on key issues affecting essential hospitals, reviewed our interaction with the Trump transition team, and looked forward to 2017. Webinar Recording
view more »CMS Issues Final OPPS Rule for CY 2017
Nov. 7, 2016 ||Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things.
view more »CMS Finalizes Site-Neutral Payment Policies
Nov. 4, 2016 ||CMS provides more flexibility than previously proposed, ensuring non-grandfathered, off-campus hospital outpatient departments will be reimbursed in 2017.
view more »CMS Issues 2017 OPPS Proposed Rule With Site-Neutral Provisions
July 7, 2016 ||America's Essential Hospitals denounces the Centers for Medicare & Medicaid Services decision to limit flexibility and withhold hospital payments for new, off-campus hospital outpatient departments.
view more »Statement on Outpatient Prospective Payment System Proposed Rule
July 6, 2016 ||Centers for Medicare & Medicaid Services' narrow interpretation of Section 603 of the Bipartisan Budget Act of 2015 threatens to reduce access to badly needed health care services in the nation's most underserved communities.
view more »Association supports bill, which would add needed risk adjustment to the Medicare Hospital Readmissions Reduction Program and provide some relief for recent cuts to off-campus hospital outpatient department payments.
view more »In letter to CMS, association raises issues of payment, definition of off-campus outpatient department of a provider, and 340B eligibility.
view more »On the Hill: Site Neutral Letter, SCOTUS Vacancy, FY 2017 Budget
Feb. 23, 2016 ||Association responds to House lawmakers' request for comment on Medicare's new payment policy for off-campus hospital outpatient departments. Congress works on FY 2017 budget, holds hearings on Zika virus and opiod abuse.
view more »CMS Answers Questions about Off-Campus PO Modifier
Feb. 3, 2016 ||The new FAQ clarify that site neutral law won't impact PO modifier requirements. PO modifiers must be included on claims as of Jan. 1 for all services and items furnished in off-campus, provider-based departments.
view more »CMS Launches Voluntary Outpatient Patient Experience Survey
Feb. 2, 2016 ||Now-voluntary OAS CAHPS will measure patient experience of care in Medicare-certified hospital outpatient departments and ASCs. The first public reporting of data is not expected until 2018.
view more »On the Hill: Omnibus and Tax Extenders Package
Dec. 16, 2015 ||House and Senate lawmakers negotiate omnibus appropriations bill and two-year extension of tax cuts, but fail to provide relief on new Medicare site-neutral payment policy for hospital outpatient departments.
view more »340B Mega Guidance: Implications for Essential Hospitals
Aug. 25, 2015 ||Participants learned about HRSA's guidance on the 340B Drug Pricing Program and how it will affect their hospital.
view more »New Law Requires Notification of Observation Status
Aug. 11, 2015 ||NOTICE Act seeks to educate patients about impact of observation status, including on cost-sharing and skilled nursing facility eligibility.
view more »CMS Releases Hospital Medicare Payment Data
June 2, 2015 ||Annual release includes 2013 data related to the 100 most common diagnoses for Medicare patients requiring inpatient stays and 30 selected outpatient procedures.
view more »CMS to Test Outpatient, ASC Patient Experience Survey
April 13, 2015 ||Preliminary testing to include random, representative sample of 50 hospital outpatient departments, 50 ambulatory surgery centers
view more »CMS Issues Final CY 2015 OPPS, PFS Rules
Nov. 10, 2014 ||Topics of member interest include payment updates, the OQR Program, and the MSSP.
view more »CMS Finalizes CY 2015 OPPS and PFS Rules
Nov. 4, 2014 ||The rules, released Oct. 31, finalized a number of provisions regarding payments, data collection in outpatient departments, quality programs, and the MSSP.
view more »Association Submits Comments on CY 2015 OPPS Proposed Rule
Sept. 3, 2014 ||The association urged CMS to revise its C-APC proposal and opposed its proposal to add a claims-based modifier for every outpatient service provided in off-campus provider-based departments.
view more »Aquí Para Ti: Health Equity for Latino Teens
Aug. 19, 2014 ||Hennepin County Medical Center's Aquí Para Ti/Here for You outpatient clinic provides aims to reduce health disparities for Latino teens using an integrated, bilingual, culturally competent approach to comprehensive youth development and primary health care
view more »CMS Releases CY 2015 OPPS Proposed Rule
July 10, 2014 ||The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. CMS also proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.
view more »CMS Issues CY 2015 OPPS Proposed Rule
July 8, 2014 ||CMS released the rule July 3. The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. In addition, CMS proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.
view more »The Ways and Means Committee reviewed hospital issues as part of the Medicare Program. Two Louisiana delegates urged CMS to accept nonprofit-provided premium assistance. The Senate Veterans Affairs Committee held a hearing featuring Secretary Shinseki.
view more »CMS Delays ASC and OQR Cataract Measure
April 8, 2014 ||The measure, OP-31/ASC-11, is part of the ASC Quality Reporting Program and the OQR Program. Data collection, which was scheduled to begin April 1, will now begin Jan. 1, 2015. America's Essential Hospitals successfully encouraged CMS to delay the measure, arguing the measure was not properly tested for the ASC and outpatient settings.
view more »CMS Seeks Feedback on Specialty Practitioner Payment Models
Feb. 21, 2014 ||CMS seeks input on models for specific procedures and complex care. These new payment and service delivery models would apply to specialty practitioner services provided in an outpatient setting.
view more »Inpatient population and sampling data for chart-abstracted quality measures for the third quarter of 2013 (discharges from July 1 through Sept. 30, 2013) will be due Feb. 8 for the IQR Program. Outpatient population and sampling data and outpatient chart-abstracted measures will be due Feb. 8 for the OQR Program.
view more »CMS Releases CY 2014 OPPS Final Rule
Dec. 3, 2013 ||The rule replaces outpatient visit codes with a single code describing all clinic visits
view more »CMS Issues Final OPPS Rule for CY 2014
Dec. 3, 2013 ||Rule finalizes several Outpatient Prospective Payment System provisions
view more »Evaluation and Management (E&M)
Nov. 25, 2013 ||Cuts to evaluation and management payments would disproportionately hurt safety net hospitals
view more »Medicaid Outpatient Regulation and Comments
Nov. 25, 2013 ||Clarifies the Outpatient Clinic and Hospital Facility Services definition, Upper Payment Limit.
view more »CMS Delays Release of CY 2014 OPPS Final Rule
Oct. 29, 2013 ||The final rule was delayed due to the partial government shutdown
view more »CMS Releases CY 2014 OPPS Proposed Rule
July 9, 2013 ||Agency seeks to understand type and frequency of, and payment for, services furnished in off-campus outpatient departments
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